PREDICTIVE VALUE OF EARLY SCINTIMETRY IN INTRACAPSULAR HIP-FRACTURES - A PROSPECTIVE-STUDY WITH REGARD TO FEMORAL-HEAD NECROSIS, DELAYED UNION AND NONUNION

Citation
Ab. Vanvugt et al., PREDICTIVE VALUE OF EARLY SCINTIMETRY IN INTRACAPSULAR HIP-FRACTURES - A PROSPECTIVE-STUDY WITH REGARD TO FEMORAL-HEAD NECROSIS, DELAYED UNION AND NONUNION, Archives of orthopaedic and trauma surgery, 113(1), 1993, pp. 33-38
Citations number
50
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Orthopedics,Surgery
ISSN journal
0936-8051
Volume
113
Issue
1
Year of publication
1993
Pages
33 - 38
Database
ISI
SICI code
0936-8051(1993)113:1<33:PVOESI>2.0.ZU;2-3
Abstract
In 84 patients with an intracapsular hip fracture, early technetium-99 m methylene diphosphonate (Tc-99m-MDP) scintimetry could be carried ou t preoperatively of in the case of conservative treatments within 72 h after injury. Fifty-four patients were available for a 3-year follow- up. The corrected uptake ratio showed a very high accuracy in predicti ng secondary dislocation, non-union (NU), delayed union (DU) or femora l head necrosis (FHN) and was far more reliable than the uncorrected u ptake ratio. The predictive value of scintimetric follow-up at a 2- or 12-week interval could not reach the same accuracy of early scintimet ry in predicting poor outcome. A comparison of follow-up scintimetry a fter conservative treatment and osteosynthesis showed that the major v ascular injury to the femoral head is caused at the moment of the init ial trauma and that no additional damage occurs perioperatively with c losed reduction and fixation with a Dynamic Hip Screw device. Scintime try is a useful tool in predicting poor outcome due to FHN and/or NU i n the treatment of intracapsular hip fractures.